Most kids battle diarrhea from time to time, but the good news is
that it's often caused by infections that don't last long and usually
are more disruptive than dangerous. Still, it's important to know what
to do to relieve and even prevent diarrhea.

Causes of Diarrhea

Diarrhea — frequent runny or watery bowel movements (poop) — is
usually brought on by gastrointestinal (GI) infections caused by
viruses, bacteria, or parasites. The specific germs
that cause diarrhea can vary among geographic regions depending on
their level of sanitation, economic development, and hygiene. For
example, developing countries with poor sanitation or where human waste
is used as fertilizer often have outbreaks of diarrhea when intestinal
bacteria or parasites contaminate crops or drinking water.

In developed countries, including the United States, diarrhea
outbreaks are more often linked to contaminated water supplies,
person-to-person contact in places such as child-care centers, or "food
poisoning" (when people get sick from improperly processed or preserved
foods contaminated with bacteria). In general, infections that cause diarrhea are highly contagious.
Most cases can be spread to others for as long as someone has diarrhea,
and some infections can be contagious even longer.

Diarrheal infections can be spread through:

dirty hands

contaminated food or water

some pets

direct contact with fecal matter (i.e., from dirty diapers or the toilet)

Anything that the infectious germs come in contact with can become
contaminated. This includes toys, changing tables, surfaces in
restrooms, even the hands of someone preparing food. Kids can become
infected by touching a contaminated surface, such as a toilet or toy,
and then putting their fingers in their mouths.

A common cause of diarrhea is viral gastroenteritis
(often called the "stomach flu," it also can cause nausea and vomiting).
Many different viruses can cause viral gastroenteritis, which can pass
through a household, school, or day-care center quickly because it's
highly infectious. Although the symptoms usually last just a few days,
affected kids (especially infants) who are unable to get adequate fluid
intake can become dehydrated.

Rotavirus
infection is a frequent cause of viral gastroenteritis in kids.
Rotavirus usually causes explosive, watery diarrhea, although not all
will show symptoms. Rotavirus has commonly caused outbreaks of diarrhea
during the winter and early spring months, especially in child-care
centers and children's hospitals, however, a vaccine now recommended for
infants has been found to prevent approximately 75% of cases of
rotavirus infection and 98% of the severe cases that require
hospitalization. Another group of viruses that can cause diarrhea in children,
especially during the summer months, are enteroviruses, particularly coxsackievirus.

Dengue fever is a tropical disease caused by a virus carried by
mosquitoes. The virus can cause fever, headaches, rashes, and pain
throughout the body. Most cases of dengue fever are mild and go away on
their own after about a week.

Dengue fever rarely strikes in the United States (the last cases were
reported in Texas in 2005), but if you plan to travel to a foreign
country — especially one in the tropics — it's wise to guard against
dengue fever. Wearing insect repellant, covering sleep areas with
netting, and avoiding the outdoors at dusk and dawn (when mosquitoes are
most active) can help lower the chances of infection.

About Dengue Fever

Dengue (DEN-gee) fever is caused by four similar viruses spread by mosquitoes of the genus Aedes, which are common in tropical and subtropical areas worldwide. When an Aedes mosquito bites a person who has been infected
with a dengue virus, the mosquito can become a carrier of the virus. If
this mosquito bites someone else, that person can be infected with
dengue fever. The virus can't spread directly from person to person.

Many kids with dengue fever don't have symptoms; others have mild
symptoms that appear anywhere from 4 days to 2 weeks after being bitten
by an infected mosquito. Symptoms typically last for 2 to 7 days. Once
kids have had the illness, they become immune to that particular type of
the virus (although they can still be infected by any of the other
three types). In rare cases, dengue fever can lead to more serious forms of the
disease. These conditions, called dengue hemorrhagic fever and dengue
shock syndrome, can cause shock and death and need immediate medical
treatment.

Signs & Symptoms

In the past, dengue fever was known as "breakbone fever," which might
give you an idea of the symptoms it can cause — that is, if a person
ends up having any symptoms at all. The fever isn't actually breaking
any bones, but it can sometimes feel like it is.

Common signs and symptoms of dengue fever include:

high fever, possibly as high as 105°F (40°C)

pain behind the eyes and in the joints, muscles, and/or bones

severe headache

rash over most of the body

mild bleeding from the nose or gums

bruising easily

Symptoms are generally mild in younger children and those who get
infected with the disease for the first time. Older kids, adults, and
those who have had a previous infection may experience moderate to
severe symptoms. People with dengue hemorrhagic fever or dengue shock syndrome will
have the regular symptoms of dengue fever for 2 to 7 days. After the
fever subsides, other symptoms worsen and can cause more severe
bleeding; gastrointestinal problems like nausea, vomiting, or severe
abdominal pain; and respiratory problems like difficulty breathing. If left untreated, dehydration,
heavy bleeding, and a rapid drop in blood pressure (shock) can occur.
These symptoms are life threatening and require immediate medical
attention.

Diagnosis

If your child has any symptoms of dengue fever, call a doctor right
away. You should also contact a doctor if your child has recently been
to a region that has dengue fever and develops a fever or severe
headache. To make a diagnosis, the doctor will examine your child and evaluate
the symptoms. The doctor will ask about your child's medical history and
recent travels, and send a sample of your child's blood to be tested
for the disease.

Treatment

No specific treatment is available for dengue fever. Mild cases can
be treated by giving lots of fluids to prevent dehydration and getting
plenty of rest. Pain relievers with acetaminophen can to treat the
headaches and pain associated with dengue fever. Pain relievers with aspirin or ibuprofen should be avoided, as they can make bleeding more likely.

Most cases of dengue fever go away within a week or two and won't
cause any lasting problems. If someone has severe symptoms of the
disease, or if symptoms get worse in the first day or two after the
fever goes away, seek immediate medical care. This could be an
indication of dengue hemorrhagic fever or dengue shock syndrome, which
needs immediate medical attention.

To treat severe cases of dengue fever at a hospital, doctors will
deliver intravenous (IV) fluids and electrolytes (salts) to replace the
fluids lost through vomiting or diarrhea.
This is usually enough to effectively treat the disease, as long as
fluid replacement therapy begins early. In more advanced cases, doctors
may have to perform a transfusion to replace lost blood. In all cases of dengue infection, regardless of how serious symptoms
are, efforts should be made to keep the infected person from being
bitten by mosquitoes. This will help prevent the illness from spreading
to others.

Cholera is a serious and sometimes life-threatening infection that
mainly affects people in developing countries, where clean water and
other sanitation measures are hard to come by. If you live in the United
States, the chances of someone in your family getting cholera are slim. But if you're planning to travel to a foreign country, especially one
in the tropics, it's a good idea to know about cholera, and how to
prevent it. Taking precautions with your food and water is the best way
to avoid the illness.

About Cholera

Cholera is an intestinal infection caused the bacterium Vibrio cholerae.
This bacterium produces a potent toxin that binds to the walls of the
intestines. The body responds by secreting large amounts of water,
causing watery diarrhea, vomiting, and subsequent dehydration as fluids and salts exit the body.

As a result, people with cholera can become dehydrated very quickly.
Untreated severe dehydration can cause serious health problems like
seizures and kidney failure. A person who doesn't get the proper medical
treatment might even die. The good news is, cholera is easy to treat if it's caught early. Kids
who have mild to moderate cases usually get better within a week. Even
people with severe cases of cholera recover fully in a week or so if
they get medical care.

Cholera is mostly found in hot, tropical climates — in particular
Asia, Africa, Latin America, India, and the Middle East. Although it's
rare in the United States (the last outbreak was in 1911), cases can
still occur. Travelers from countries where cholera is more common can
bring it into the country, and some people in the U.S. have become sick
from eating raw or undercooked shellfish from the Gulf of Mexico.

How It Spreads

People get cholera from eating or drinking food or water that's been
contaminated with the feces (poop) of someone who has cholera. This is one reason why cholera is rare in countries with good
sanitation systems. Things like flush toilets, sewer systems, and water
treatment facilities keep poop out of the water and food supply. Cholera
epidemics also sometimes happen after a disaster (like an earthquake or
flood) if people are living in tent cities or other places without
running water or proper sanitation systems. Less commonly, the bacteria
that cause cholera are found in brackish rivers and coastal waters. Cholera is not contagious, so you can't catch it from direct contact with another person.

Signs & Symptoms

When someone is infected with the cholera bacterium, symptoms can
appear in a few hours or as late as 5 days later. Many kids with cholera
have no signs or symptoms, but some cases can be severe and life
threatening.

Common symptoms of cholera and the dehydration it causes include:

watery, pale-colored diarrhea, often in large amounts

nausea and vomiting

cramps, particularly in the abdomen and legs

irritability, lack of energy, or unusual sleepiness

glassy or sunken eyes

dry mouth and extreme thirst

dry, shriveled skin

low urine output and a lack of tears

arrhythmia (irregular heartbeat) and low blood pressure

If your child develops symptoms like these, especially after visiting
an area where cholera is likely or common, call your doctor or get
medical help right away. Severe dehydration can happen very quickly, so
it's essential to start replacing lost fluids right away to avoid damage
to internal organs.

Diagnosis

To confirm a diagnosis of cholera, doctors may take a stool or vomit
sample or a rectal swab to examine for signs of the bacteria. Rapid,
dipstick-style tests are now available, which help health care providers
in remote areas identify the disease more quickly and control outbreaks
more effectively. All confirmed cases of cholera must be reported to
local health officials.

Treatment

Since severe dehydration and death can occur within hours, cholera
needs to be treated immediately. Most kids recover with no long-term
problems as long as they receive prompt treatment. The goal of treatment is to replace all the fluids and salts lost
through diarrhea and vomiting. For mild dehydration, a doctor may
recommend giving your child an over-the-counter rehydration solution.
Kids with more severe cases of cholera may need to stay in the hospital
and get intravenous (IV) fluids.

Sometimes doctors prescribe antibiotics to treat cholera. The
antibiotics are not as important as rehydration, but can help shorten
the length of time someone is sick. They also might make cholera-related
diarrhea less severe. Sometimes doctors also prescribe zinc
supplements. Anti-diarrheal medicines can actually make the symptoms of cholera worse, so if your child has cholera (or you think your child has it), do not offer them.

Appendicitis (inflammation of the appendix) requires immediate
medical attention, so it's important to learn its symptoms — and how
they differ from a run-of-the-mill stomachache — so you can seek medical
care right away. The first symptoms of appendicitis usually are a mild fever and pain
around the bellybutton. The pain usually worsens and moves to the lower
right side of the belly. Vomiting, diarrhea or constipation, and loss of
appetite are other common symptoms. Call your doctor immediately if you suspect that your child has
appendicitis. The earlier it's caught, the easier it will be to treat.

About Appendicitis

The appendix is a small finger-like organ that's attached to the
large intestine in the lower right side of the abdomen. The inside of
the appendix forms a cul-de-sac that usually opens into the large
intestine. Blockage can be due to hard rock-like stool (called a fecolith),
inflammation of lymph nodes in the intestines, or even parasites. Once
the appendix is blocked, it becomes inflamed and bacteria can overgrow
in it. If the infected appendix isn't removed, it can burst and spread
bacteria. The infection from a ruptured appendix is very serious — it
can form an abscess (an infection of pus) or spread throughout the
abdomen (this type of infection is called peritonitis). Appendicitis mostly affects kids and teens between 11 and 20 years
old, and is rare in infants. It's one of the most common reasons for
emergency abdominal surgery in kids. Appendicitis is not contagious.

Symptoms

significant abdominal pain, especially around the bellybutton or in
the lower right part of the abdomen (perhaps coming and going and then
becoming consistent and sharp)

low-grade fever

loss of appetite

nausea and vomiting

diarrhea (especially small amounts, with mucus)

swollen or bloated abdomen, especially in infants

There is no way to prevent appendicitis, but with sophisticated
diagnostic tests and antibiotics, most cases are identified and treated
without complications. If appendicitis goes untreated, the inflamed appendix can burst 24 to
72 hours after the symptoms begin. If the appendix has burst, the pain
may spread across the whole abdomen, and the child's fever may be very
high, reaching 104°F (40°C). The symptoms of appendicitis can vary according to a child's age. In
kids 2 years old or younger, the most common symptoms are vomiting and a
bloated or swollen abdomen, accompanied by pain. If you suspect that your child has appendicitis, call your doctor
immediately and don't give your child any pain medication or anything to
eat or drink unless instructed to by the doctor.

What Is a Body Piercing and What Can You Expect?

A body piercing is exactly that — a piercing or puncture made in your
body by a needle. After that, a piece of jewelry is inserted into the
puncture. The most popular pierced body parts seem to be the ears, the
nostrils, and the belly button. If the person performing the piercing provides a safe, clean, and
professional environment, this is what you should expect from getting a
body part pierced:

The area you've chosen to be pierced (except for the tongue) is
cleaned with a germicidal soap (a soap that kills disease-causing
bacteria and microorganisms).

Your skin is then punctured with a very sharp, clean needle.

The piece of jewelry, which has already been sterilized, is attached to the area.

The person performing the piercing disposes of the needle in a
special container so that there is no risk of the needle or blood
touching someone else.

The pierced area is cleaned.

The person performing the piercing checks and adjusts the jewelry.

The person performing the piercing gives you instructions on how to
make sure your new piercing heals correctly and what to do if there is a
problem.

Before You Pierce That Part

If you're thinking about getting pierced, do your research first. If
you're under 18, some places won't allow you to get a piercing without a
parent's consent. It's a good idea to find out what risks are involved
and how best to protect yourself from infections and other
complications. Certain sites on the body can cause more problems than others —
infection is a common complication of mouth and nose piercings because
of the millions of bacteria that live in those areas. Tongue piercings
can damage teeth over time. And tongue, cheek, and lip piercings can
cause gum problems.

Studies have shown that people with certain types of heart disease
might have a higher risk of developing a heart infection after body
piercing. If you have a medical problem such as allergies, diabetes,
skin disorders, a condition that affects your immune system, or
infections — or if you are pregnant — ask your doctor if there are any
special concerns you should have or precautions you should take
beforehand. Also, it's not a good idea to get a body piercing if you're
prone to getting keloids (an overgrowth of scar tissue in the area of
the wound).

If you decide to get a body piercing:

Make sure you're up to date with your immunizations (especially hepatitis B and tetanus).

Plan where you will get medical care if your piercing becomes
infected (signs of infection include excessive redness/tenderness around
the piercing site, prolonged bleeding, pus, and change in your skin
color around the piercing area).

Also, if you plan to get a tongue or mouth piercing, make sure your teeth and gums are healthy.